This morning we were suppose to be picked up at 7:15 but our driver didn’t get here until 8 or so. We learned it was because he was up until 5 waiting to pick up the newcomers. We finally got a full tour of the hospital from the internal med intern that I’ve worked with these past two days. So, internal med was pretty awesome again today. It started a little late and got done a little late but it was interesting to see all the various diseases – malaria, HIV, TB, silicosis, etc. One scary incident happened when a patient with delirium was yelling, jumped out of bed, rolled around on the ground, got up and tried to punch a male nurse. Luckily the male nurse was a bit bigger than the patient and got him to the floor to be sedated. I was about to jump in and show off my kung fu moves but then I remembered I didn’t have any… Afterwards we went to the place we seem to always go called Njiro complex. It has free wifi and you sit down outside and they give you a bunch of different menus to order from. So, pretty much they have something for everyone. Today I got some pizza that was a little bit too spicy for me – but it was delicious. Afterwards we went and saw the new wolverine movie which I found a little too corny. When we all got to the house we met the newcomers and talked in our British accents. We managed to talk so well that we convinced them we were from the UK so kudos to us. Tonight we are just staying in and playing card games and hopefully going to bed early… So I’m starting to feel more comfortable in a country so far away from home that speaks a different language. I think I’ve decided to accept my role as a mzungu (foreigner). This is nice because it means I’m comfortable standing out and wearing what I would normally wear (aka shorts). We talked about this in the house today: it’s actually felt pretty safe here. I mean, obviously I’m not going on any midnight runs, but it’s felt safe. At no time have I felt in any danger (other than today in the internal med ward – which wasn’t any actual danger). It’s also easier to feel safe when we have a security watchmen 24/7 and the night watchmen has a bow an arrow (used for shooting thieves, he tells us).
Today I started shadowing in internal medicine and it was awesome. I was able to see a lot of interesting diseases and pathologies such as TB, malaria, ascites, and stroke. The doctors were a bit better in that they understood where we were exactly in our schooling so they asked questions we could answer and also explained things to us. I also learned today that in Tanzania you go to primary school and then high school, but in high school they can do either a 4 year track or a an accelerated 2 year track. After that, they go to medical school for 5 years, have 1 year of intern year and then are practicing doctors. I’m pretty sure the doctor I shadowed today was actually younger than me, which is strange because I’m sooo many years away from being a practicing doctor. In the internal med ward, we were able to see about 30 patients and it started a little late so we got done a little late. We had lunch at a place called Fifi’s and then mostly bummed around and had a few drinks for the rest of the night. We were expecting the new Elective Africa volunteers to arrive but it seems they won’t be here until after we go to bed.
To my 8 fans, I apologize for the long delay and keeping you in such unbearable suspense.
Last night we all went to bed early. They had the same entertainment as the night before but we didn’t stick around to watch. Pat and I did look up at the stars for a little bit, though. Pat and I were also the only ones to get up for the sunrise. It was a bit like yesterday and we only saw the full circle of the red sun before it disappeared into some clouds. We went to the Tarangire preservation today. Around 9 in the morning we arrived and an hour in we encountered some lions about to mate. The first time they mated, it only lasted about 10 seconds. There was about a 3-5 rebound period and then another minute or two of mating. We got some pretty good photos of it. We didn’t get to see a leopard today or a rhino up close. We did see a lot of animals more up close than yesterday. Of the new animals, we saw waterback vulture, white-headed buffalo wearer, rock high rat, tree high rat, king fisher, taway eagle (sp?)m banded mongoose, and Egyptian goose,. My favorite of the safari places was the Ngorogoro crater. The scenery was just more beautiful with the frosted covered mounds and the large plains. Tarangire was a bit of a mix between Ngorogoro and Manyara. Ngorogoro had the plains and Manyara had the trees. Tarangire was somewhere in between. Once we got home we said goodbye to the girl who had been staying at the same house as us. Hopefully we have learned enough from her to feel comfortable traveling around the city. There are two new people coming tomorrow from Michigan so hopefully we know enough to at least show them some of the ropes. Tomorrow I will be trying to shadow in the internal medicine ward. Hopefully it will be as good or better than the pediatrics ward. I’m excited for a change of scenery and working with a new doctor – well, actually i think I’ll be working with an intern. Also, I’m hoping there won’t be quite as many students following the same person. Tonight s just a night to chill, relax and shower before tomorrow begins. Oh, one more thing, I would say that i highly recommend the Congema safari company to anyone considering doing a safari. They were able to answer all of our questions about animals and the landscape. Their food was also very good and the places we stayed at were comfortable. Also, I highly recommend going on a safari. It’s one thing to see an animal in the zoo but it’s a completely different thing seeing them in the wild, in their natural habitat, with nothing more than a car door (if that) between you and the animal. Also, it’s a different experience to ahve that slight worry that an elephant is going to charge your vehicle. Our safari guide told us he once had an elephant charge his vehicle and its tusk went through the car door. Also, on a safari, you don’t have that sad feeling of seeing wild animals in cages.
Last night after dinner there were three people here from a nearby tribe that did a bunch of acrobatic things. I was a bit terrified for them because they were doing it on cement. During one act there was a guy doing handstand pushups on top of 3 stacked wood blocks for each hand. At the end he pushed the blocks away and caught himself while staying in a hand stand. Oh yeah, he was also on top of two benches while he did this. The stars last night were absolutely incredible. If I saw any constellations that I know, I wouldn’t have been able to recognize them because of how many stars there were. Unfortunately, we had to wake up early so I wasn’t able to stay out and look at them for too long. There also wasn’t a very good place to see them through the trees. The number of trees are one thing that I have realized is different. if you were to look down at a small city in Iowa, you would see many buildings with a tree here and there. In Arusha, there are trees and green everywhere with the buildings. So day 2 of the safari was at Ngorongoro crater. It was amazing. A giant hole with plains and animals surrounded by a circle of mounds/hills. Even more impressive was the clouds that sat on top of the mounds as if it were frosting on a cake. It was a very different environment than yesterday. In Ngorongoro, there are large herds of animals. In one region there is a tribe called the Masai that live alongside the animals. Our driver told us not to take pictures of the Masai because, if we do they’ll ask for money and if we don’t pay they would break our window. The Masai are known for their warriors but also known for rejecting the western values and live more traditionally. We have seen a number of Masai people at Mt. Meru hospital however. Today at the safari we were able to see many of the same animals as yesterday as well as many new ones. The new animals we saw were female lions, a male lion, some type of cat that looked like a mini cheetah, a rhino from a distance, ostriches, golden and silver backed jackal, hippo, warthog, cape buffalo, secretary bird, kori bastard (?). At one time we saw a lion in some tall grass waiting for a zebra to come by to pounce on. The zebra eventually got within 10 feet or so (considered a distance lions will attack from) but the lion didn’t pound and eventually the zebra realized what was up and ran away. My favorite animal was the male lion but my favorite moment was when I was about 10 feet away from a female lion (in the safari vehicle of course). Tomorrow we are going to Tarangire preservation and that will be the last place we go. I’m staying at the same place as yesterday. I’ll have to wait and see if there will be similar entertainment as yesterday.
We went to a bar last night called Via Via that was pretty awesome. It had a big open area outside and a dance floor that was also outside. The people I’m with and I decided it was a good idea to speak in an English accent all night. We even created new names for each other – mine was Henry. Once we got confident in our accents we went and talked to some people from California and convinced them we were from different parts of England. My English accent sounds like an Irish accent periodically so my story was that I studied abroad in Ireland for a year. The people from the pediatrics ward that were from England showed up later on and told us that our accents were completely awful. So we’ll still have to keep working on them. Interestingly enough, today some of us have problems not speaking in an English accent. At one time later in the night, they cleared off the dance floor and had a bunch of people break dancing and doing some traditional Tanzanian dancing. It was really cool for the first ten minutes but after that it got a little boring – it must have lasted longer than 30 minutes total… so, today was the first day of our safari. we went to Manyara lake/preservation and were driven around in a safari car for about 6 hours. We were able to see a lot of different animals (A lot of the animal names are spelled wrong, or are just completely wrong due to difficulties in fully interpreting our tour guide): baboon, velvet monkey, impala, water buffalo, wildebeast, thompson gazelle, super blue starling, crowned crane, little egret, zebra, flamingo, elephant, smallest antelope in Africa (dikdik?), giraffe, and eagle. My favorite for the day was the giraffe. The “big five” is considered the lion, leopard, water buffalo, rhino, and elephant. Hopefully we will see the other three tomorrow. I’m most hoping to see a lion. I plan on getting a few paintings from here but my current rule is that if I don’t see the animal on the safari, I won’t buy a painting of it. That may change if I don’t see a lion though. Tomorrow we are going to the Ngorongoro crater. Tonight we are staying in the place that runs the safari (this may not have been true). We are staying in tents that have two small beds in each. It should be okay, though. I’m excited for the showers here because they appear to actually work and may even have warm water. Tomorrow we are waking up early to see the Tanzanian sunrise.
Last night we went to a mzungu bar called the Mango Tree. Mzungu is swahili for foreigner. Needless to say, there was a lot of white people. I tried a new beer called Ndovu. It was a lager that reminded me of bud light and I really didn’t like it all that much. We got to the hospital later than yesterday. When we got there, they had all of the pediatrics patients out of the pediatrics ward because they were cleaning it. So we didn’t end up doing anything until rounds started at 10:30. There was the same Tanzanian doctor as yesterday and she kept asking us questions, which was great, but I don’t think she knows that we are only done with one year and don’t know much of anything. I found out that not all the students were from London but instead from different places in England and Scotland (and Australia, Ireland..). They were able to sort of answer questions since they have finished at least four of their five years. Today was my last day in the pediatrics ward. Pat and I are thinking of switching to Internal Med come Monday. We had lunch at the same area as yesterday then went to the movie theater and saw Despicable Me 2. The movie was pretty great. Tonight we have our Safari briefing and they are also giving us barbecue. I’m excited for the barbecue but more excited for the safari which starts tomorrow. After we eat tonight, I’m going to bathe/shower and then it’ll be off to another mzungu bar. Tonight is apparently the night that everyone goes out soooo it should be an interesting time.
At the barbecue waiting for some grub.
One of our cooks for the barbecue. He was actually our night watchman/security guard who always carried a bow and arrow with him!
Beer is beer. We asked our program coordinator how to say “beer” in swahili and he said “beer is beer.” Well, that makes things easy. We got to the hospital early today and were able to participate in pre-rounds with the physicians and interns. That was really interesting. Then after we went and saw patients but a bunch of other students joined us like yesterday. So it wasn’t all that great. One of the inters or doctors there was asking us a lot of questions about malaria and no one really know the answers so I looked them up once we were done for the day and went to a wifi spot. So I was able to learn a few more things today. There was a nurse practitioner that Chad and Kirsten worked with who was with the same program as the doctor from Oregon. She taught us what you do right after a baby is born if it is not breathing. She had some model babies that we could practice on. After that we had lunch and I couldn’t resist just getting a burger and fries (they call them chips here). The food was okay but nothing special. I think I should stay to more local food to make sure I get the full effect of being here. So far on our trip I have had 4 different types of Tanzanian beer. Three were lagers and one was darker. The three lagers were okay. They were called Kilimanjaro, Serengeti, and Tusker. The dark beer was pretty good and called Faru. After lunch we went to an orphanage that was started by a couple from Texas. There were a lot of small children there and it was interesting to hear about all their stories. It as fun to play with them too but we really didn’t stay too long. I imagine we will go back. I have to say that throughout the past year I really struggled on thinking whether or not I made the right career chioce for myself. I mean if I wanted to help people or have a positive impact and just that, then there are a million other options I could have chosen that did not require so many damn years of hard work. And a million other options that could allow me to start actually doing something right away. But after today I feel I was reminded why I chose medicine and to become a doctor. Watching the doctors, nurses and interns interact and discuss the patients’ problems and treatment options made me realize how interesting it truly is. It made me realize that I want to be that intern or doctor who knows how to diagnose malaria, how to treat it, and the reasons why not to give this drug because it will interact with another drug. While pharmacology may not be the most interesting subject, seeing how much it comes up here will hopefully give me some motivation to truly learn it when I take it this upcoming semester. Also, although I still don’t think pediatrics is for me, one benefit of it is you get to help patients who truly could not help themselves or prevent their illness. It seems like this may be a little more rewarding than helping patients who are in the hospital for obesity or smoking problems that refuse to try and make a change or quit. Then again, we all have our demons. Anyways, that was quite a rant.